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A New Technique of Medial Canthal Tendon Reconstruction using a Transcaruncular Fixation Approach
Oluwaseun A. Adetayo, MD1,2, Jeffrey A. Fearon, MD3, Sanjay Naran MD1,2, Susan E. Stefko, MD1,4 , Joseph E. Losee, MD1,2
1) Children's Hospital of Pittsburgh of UPMC
2) Department of Plastic Surgery, University of Pittsb
2013-03-07
Presenter: Oluwaseun A Adetayo
Affidavit:
This work represents the original work of the authors. The presenting fellow has mad primary contribution to the study design, data analysis, and final editing of the work herein.
Director Name: Joseph E. Losee
Author Category: Fellow Plastic Surgery
Abstract Category: Craniomaxillofacial
ABSTRACT
Background and Purpose: Medial canthal tendon reconstruction following traumatic detachment poses a reconstructive challenge in fixation and longevity. The aim of this study is to present a clinical series in which a new technique of fixation, the transcaruncular medial transnasal canthoplasty, was used to manage post-traumatic medial canthal tendon injuries.
Methods: A retrospective study was conducted in which a clinical series of patients were treated with transcaruncular medial canthal tendon reconstruction. A transcaruncular incision is created between the caruncle and plica semilumaris. Dissection is completed in the subperiosteal plane to the posterior lacrimal crest. A Tessier awl is introduced through a contralateral transcaruncular incision posterior and superior to the posterior lacrimal crest. A wire needle is passed through the Tessier awl and fixation over a plate is used to achieve transnasal medial canthal tendon fixation.
Results and Conclusion: This technique provides an effective and durable medial canthal tendon reconstruction. No cutaneous scars are produced with this technique, although existing scars can be used for access. In this series, the transnasal medial canthoplasty using a transcaruncular approach is a safe, effective, and expedient technique for medial canthal tendon reconstruction and should be considered for patients with post-traumatic medial canthal tendon reconstruction.
